树脂血液灌流治疗毒鼠强中毒的疗效观察

Effeet of resin haemoperfusion on treating tetramine poisoning

目的 评价HA型血液灌流器清除人体内毒鼠强 (tetramine)的效果。方法 (1) 12例毒鼠强中毒患者入院后 ,选用HA型血液灌流器 (由苯乙烯 二乙烯苯聚合而成的高分子大孔树脂作为吸附剂 )进行血液灌流治疗 ,用气相色谱法分别测定毒鼠强中毒患者入院、灌流即刻、灌流结束时及结束后不同时间点血液毒鼠强浓度。 (2 )气相色谱法测定HA型血液灌流器中毒鼠强的吸附量。结果 (1)随入院时间的推移患者血中毒鼠强浓度呈逐渐下降趋势 ,其降低幅度与HP治疗次数及每次HP的间隔时间有关 ,即在HP集中治疗阶段 (每日或隔日一次 ) ,血中毒鼠强浓度呈较大幅度下降。 (2 )HA - 330ml灌流器在开始治疗时血毒鼠强浓度为 2 19～ 5 4 μg L之间 (平均值为 117 4 μg L) ,吸附毒鼠强的含量范围在 4 385～ 0 836mg之间 (平均值为 2 0 3mg) ;HA - 2 30ml灌流器在毒鼠强血药浓度在 192～ 5 5 μg L范围 (平均 115 μg L)时 ,吸附毒鼠强的含量在 2 375～ 0 32 8mg之间 (平均值 :1 5 0 8mg)。结论 (1)血液灌流能有效清除人体内毒鼠强 ;(2 )在血TETS浓度 10 0 μg L左右时 。

Objective To evaluate the clearance efficacy of HA-haemoperfusion cartridge on treatment of tetramine poisoning.Methods Twelve patients with tetramine poisoning were treated with HA sterile haemoperfusion cartridge(ploy meric adsorbents).Tetramine concentration in blood samples at hospitalization,start point and end point of haemoperfusion,and different time points after haemoperfusion quantitatively analysed with gas chromatography.Results (1)The plasma tetramine concentration was reduced after hospitalization,and the reduction was associated with interval and times of haemoperfusion.(2)When tetramine concentrations were between 54～219 μg/L and 55～192 μg/L at the beginning of HP,0.836～4.385 mg and 0.328～2.375 mg tetramine could be adsorbed by HA-330ml and HA-230ml cartridge respectively.Conclusion (1)Haemoperfusion can effectively remove tetramine from human body.(2)Resin cartridge could possibly adsorb more tetramine than activated charcoal cartridge when the plasma concentration was about 100 μg/L.